title: [Primary health care and family medicine--possibilities for treatment of opiate addicts].
abstract: The global trend of promoting management and treatment of drug addicts in family physician offices is the result of the success of opioid agonist therapy. Studies have shown favorable results by shifting treatment into the hands of family physician. This process contributes to general health care of drug addicts and their health by linking different areas of health care, thereby providing comprehensive protection. Shifting treatment of addiction to family physician offices contributes to the elimination of treatment isolation and stigmatization, while further benefits are lower barriers to employment, increase in patient privacy and opportunity to provide health care. The aim of this study was to provide a concise overview of the knowledge from new clinical research over the past ten years on heroin addiction treatment in primary care. New research dealing with the approach to treating addicts indicates a direct link between receiving primary health care with a reduced likelihood of using heroin; furthermore, the main concerns of drug addicts for treatment are availability of more therapeutic programs, better functioning of existing programs, and improved staff relations towards them; final results and outcomes achieved by office and hospital treatment of drug addicts are similar and confirm the positive linear relationship between treatment duration and outcome. Studies comparing therapies show a positive effect of the adaptive methadone treatment maintenance model on the psychosocial factors; equal efficiency of treatment regardless of initiation with buprenorphine or with methadone; and equal effectiveness of levo-alpha-acetylmethadol treatment compared with methadone and diacetylmorphine as a good alternative for addiction therapy with previously unsatisfactory results. New studies on buprenorphine show equal effectiveness and cost of detoxification whether guided by a family physician or at the hospital; non-supervised therapy does not significantly influence the outcome, but is significantly cheaper; long-term therapy with buprenorphine in the doctor's office shows mild retention.
authors.affiliation: Sveuciliste u Zagrebu, Medicinskifakultet, Skola narodnog zdravlja Andrija Stampar, Katedra za obiteljsku medicinu, Zagreb, Hrvatska. htiljak@snz.hr
authors.forename: Hrvoje
authors.initials: H
authors.lastname: Tiljak
authors.forename: Ivana
authors.initials: I
authors.lastname: Neralić
authors.forename: Venija
authors.initials: V
authors.lastname: Cerovecki
authors.forename: Andrej
authors.initials: A
authors.lastname: Kastelic
authors.forename: Zlata Ozvacić
authors.initials: ZO
authors.lastname: Adzić
authors.forename: Anja
authors.initials: A
authors.lastname: Tiljak
mesh_terms: D005194:Family Practice; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D058850:Opiate Substitution Treatment; D011320:Primary Health Care